Report shows UK lags behind Europe in cancer survival

Cancer survival in Europe is improving but the UK is still lagging behind, according to two reports carried out by the EUROCARE group released on August 21 in The Lancet Oncology journal.

Cancer survival in Europe is improving but the UK is still lagging behind, according to two reports carried out by the EUROCARE group released on August 21 in The Lancet Oncology.

Nordic countries (except for Denmark) and central European countries performed best in the survey; survival of the four most common cancers (colorectal, lung, breast and prostate), and for ovarian cancer was highest in these countries, intermediate in southern Europe, lower in the UK and Ireland, and lowest in Eastern Europe.

The first report analysed data from 83 cancer registries in 23 European countries on 2.7m adult cancer cases that were diagnosed between 1995 and 1999 and followed up to December 2003.

"Cancer survival in the UK is still below the European average and similar to some eastern European countries that spend less than one third of the UK's per capita healthcare budget," it said.

According to the report, Finland had high all-cancer survival but only moderate total national health expenditure (TNEH).

Survival differences

Although the findings suggest a substantial improvement in cancer care in countries with poor survival, the authors conclude that differences in survival for individual cancers between countries and regions remain.

"If all countries attained the mean survival (57 per cent) of Norway, Sweden, and Finland (countries with high survival and medium-to-high TNEH), about 12 per cent fewer cancer deaths (about 150 000) would occur in the five years after diagnosis," stated the report.

The second report estimates survival of patients diagnosed more recently in 2000-2002 by country and cancer site, assesses survival changes in Europe, and compares findings with data on cancer survival in the US for patients diagnosed in the same time period.

Survival for patients diagnosed between 2000 and 2002 was generally highest in northern Europe, especially Sweden, and lowest in Eastern Europe, especially the Czech Republic and Poland.

Patients in Eastern Europe did have the largest improvement in survival, however, and so the gap between Eastern Europe survival and other European areas is decreasing.

Survival for patients with solid tumours was lower in Europe than for US patients. Five year survival in the US for all cancers combined was 66.3 per cent in men and 62.9 per cent in women; both these percentages were significantly higher than those for Europe - 47.3 per cent for men and 55.8 per cent for women.

The authors claim that the differences in survival are due to a variety of reasons including factors relating to cancer services, such as organisation, training and skills of healthcare professionals, application of evidence-based guidelines, and clinical factors, such as tumour stage and biology.

Improvement on earlier report

Professor Richard Sullivan, Cancer Research UK's director of clinical programmes, said the figures showed encouraging improvements for the UK.

"Partly as a result of the political impetus provided by the first Eurocare study, the NHS Cancer Plan was published to reorganise, standardise and rejuvenate cancer services. Although these figures don't cover much time since the Cancer Plan was introduced, they show how it had already begun to make a difference."

The UK cancer tsar Mike Richards said that poor UK results in previous Eurocare studies were down to late diagnosis of the disease.

The NHS Cancer plan was launched in 2000 and aimed to reduce death rates and improve prospects of survival and quality of life for cancer sufferers by improving prevention, promoting early detection and effective screening practice, and guaranteeing high quality treatment and care throughout the country.

Although Sullivan pointed out that comparisons between countries were difficult because of the different way data is collected, he also believes early diagnosis is the key to improvement.

"Cancer is still not being diagnosed early enough in all cases. And we need to ensure that patients have access to the best surgery, radiotherapy and other treatments. This study shows that cancer is certainly not a 'ticked box'. We need a sustained effort to beat the disease."